I broke my arm recently. I was biking near my house and I looked away for
about 15 seconds and when I turned back around my bike and I were laid out on
the street. And as I went down, face first into the pavement, my first thought
was: I hope I don’t have to go to the doctor.

I’ve always had a skewed relationship with the medical industry. In
Nicaragua, the few times I went to a doctor it was really bad. I saw a doctor
when I had hepatitis, varicella, and when my parents were told I was clinically
malnourished. When you grow up poor, doctors are your last resort. Often medical care just isn’t an option. People use home remedies or salves passed
down through generations. We had to cure ourselves or get together as a
community to cure one another.

In the United States I was able see a doctor more regularly because we had Medicaid.
My mother was diligent in getting us the care that we hadn't received in
Nicaragua. When you’re in those kinds of systems you don’t really have a
primary care provider. My doctors never really knew me, and I really didn’t
know them.

My mother and father quickly discovered the black market because they had
aged out of any assistance. They did what any person with limited income does:
got sharper than the system. When you know that legal system is not really
meant to protect you, things like the medical black market become less
ethically problematic. You learn this growing up in the 'hood. You learn to
outwit systems that want to erase you.

My mother had established a relationship with a woman in the black market, and I never really needed to see a doctor by the time I aged out of Medicaid
and was no longer covered. Then I got into Vanderbilt University and part of
the admissions process demands that you have buy into the university insurance.
I was covered again! But by this time I had already developed a habit of not
relying on modern medicine or state-sanctioned care, so I barely used it.

Then I learned about the Tuskegee study and Henrietta Lacks and the forced
sterilization of Latinas, and my mom told me a really weird story about how she
had something similar to the NuvaRing implanted in her by her doctor, and you
start to suspect that maybe she was tested on as well. The implant was metal
and it rusted and it made her sick and my already healthy distrust for the
medical industry hardened to disdain. There are studies that prove that the
care given to people of color in hospitals is inferior compared to whites, which
makes perfect sense when I put it into the context of what I experienced
growing up.

When I fell off my bike, face first, onto the pavement, I wanted to cry
because I no longer have coverage and I no longer trust the system.

Working poor people of color know that the medicine industry was never meant
to protect us, so we have protected ourselves and we have resorted to going into
emergency rooms for immediate care.